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“It’s not just a spliff round the barbecue”

A survey of a cross-section of lawyers in the UK finds that at least 27 percent of them regularly uses recreational drugs – and dangerously strong and addictive drugs at that.

image001“And a startling 22 percent of barristers that take drugs have indulged while at their chambers’ desk or in the lavatories,” the survey said.

The survey, performed by Legal Cheek, a popular UK legal news journal, said that the favored drugs were not a bit of weed now and then.

“It’s not just a spliff round the barbecue,” said the survey. “Nearly 80 percent of users are keen on class-A gear… the survey shows they have a taste for the hard stuff.”

By ‘class-A gear’ the survey refers to the UK equivalent of Schedule 1 or 2 drugs in the U.S. – opioids, cocaine, crack, methamphetamines – all the most dangerous and addictive drugs.

“Of those currently taking drugs, almost all at least occasionally indulge in class-A. Indeed, 89 percent said they take cocaine or crack, albeit with only 9% doing the latter,” the survey said.

Another 77 percent of lawyers currently taking drugs said they were keen on Ecstasy/MDMA, while 30 percent expressed a ‘retro fondness’ for psychedelics such as LSD.

image003“But marijuana is the most popular drug for lawyers,” said the survey. “Of those currently taking drugs, 93 percent said they enjoyed a spliff. Slightly more than 40 percent go for ketamine, while nearly the same percentage opts for magic mushrooms.

“Strikingly, four lawyers said they were currently at least occasionally enjoying the delights of heroin,” the survey added.

The survey uncovered strong support among UK lawyers for the “complete decriminalization of all drugs.” This opinion of the legal profession “flies in the face of recent government moves to ban a range of so-called legal highs,” according to the survey. “Some 54 percent of lawyers said drugs should be made legal, indicating that many of those in the front line of the ‘war on drugs’ — either prosecuting or defending dealers and users — reckon the battle is lost.”

While more than one lawyer in four was currently taking drugs, the survey found that overall use is “much higher. Nearly 60 percent of lawyers said they had at some stage in their lives taken illegal drugs.”

Another finding suggests that personal wealth influences drug habits. “Perhaps because their remuneration packages are far weightier, those solicitors practicing corporate-commercial law are more likely to take drugs than their counterparts slaving away at general practices,” said the survey. Roughly 56 percent of solicitors currently taking drugs work at commercial law firms, while only 36 percent are at the lower-paying general practices.

Criminal lawyers were “leading the way” in drug abuse – more than 60 percent of those currently taking drugs. Only 22 percent were in common law practices.

image005 These findings are expected to “trigger some dismay” within the UK government, following an announcement to put before parliament the “Psychoactive Substances Bill” that proposes to “prohibit and disrupt the production, distribution, sale and supply of new psychoactive substances in the UK.”

In other words, it’s designed to crack down on what is seen as an increasing public interest in what can be called “legal highs.” The law would ban a wide range of substances, including the sale of nitrous oxide — more commonly known as “hippy crack” or “laughing gas.”

Mike Penning, Minister of State for Policing, Crime, Criminal Justice and Victims, said: “The landmark bill will fundamentally change the way we tackle new psychoactive substances — and put an end to the game of cat and mouse in which new drugs appear on the market more quickly than government can identify and ban them.”

Legal Cheek says that the professional implications for lawyers busted for doing drugs “remain vague.” Regulators apparently approach such situations on a “case-by-case approach.”

“For example,” says Legal Cheek, “the UK’s Solicitors Regulation Authority maintains that even a minor drugs conviction is likely to be considered a breach of rule 1.06 which states ‘you must not behave in a way that is likely to diminish the trust the public places in you or the profession’.

A UK legal authority told Legal Cheek that lawyers caught using drugs may be required to appear before a Solicitors Disciplinary Tribunal, and that any penalty “would largely depend on the circumstances.”

Lawyers convicted in a court of law for a drugs offence, or those reported for abusing drugs to the UK’s Bar Standards Board could get anything from a tap on the shoulder to disciplinary action.

It’s obvious from this survey that a lot of lawyers in the UK are messing around with drugs, and a lot more serious drugs than we feel comfortable with, considering that we put so much trust in our lawyers to protect our interests. What kind of defense can a lawyer put up for us if he’s just taken psychoactive drugs in the court washroom before addressing the judge or jury?

We aren’t aware of any similar survey here in the U.S. We can probably safely assume that there is a similar level of recreational drug use. If you’ve heard of any such survey of American lawyers regarding recreational drug use or any special or other treatment for drug offences in courts, by law societies or by Bar associations, we’d love to hear from you. Maybe we could do a U.S.-based blog on the topic.

Meanwhile, if you or someone you care for needs some expert help for drug or alcohol problems, don’t hesitate to call Novus today. We’ll do our best to explain all your options and help steer you to the best solution.

PICTURE CREDITS: Legal Cheek Ltd.

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Forget about brewing up some boring old home-made beer. In the near future it’s going to be possible to whip up a batch of morphine or codeine right in your own kitchen – and you’ll use your own homemade beer-brewing kit and some very special brewer’s yeast to do it!

Scientists at the University of California, Berkeley (UCB), have just shown that it can be done – synthesize opioids such as codeine and morphine from special sugar from sugar beets combined with brewer’s yeast.

Of course, the article in Nature Chemical Biology was careful to point out that they concocted their home-made morphine in a lab, under strictly controlled conditions using genetically engineered sugar beets and yeast (with a some other foreign DNA tossed in).

In spite of all the tricky science, they’re saying that before too long, the process could be simplified enough to be carried out under less rigorous conditions. And many other scientists who’ve seen the UCB study agree.

“It is going to be possible to ‘home-brew’ opiates in the near future,” said Christopher Voight of the Massachusetts Institute of Technology (MIT), who was not involved in the research.

The process described in the study was inefficient, to say the least. It took 300 liters (nearly 80 gallons) of genetically engineered yeast to produce a single 30 milligram dose of morphine.

“But with improvements that are well within reach, that dose could be obtained from a glass of yeast culture grown with sugar on a windowsill,” Voight said.

Opioids – the go-to drugs for over 6,000 years

Morphine and other opioids have been the standard drugs for serious pain relief for thousands of years – in fact, their use predates recorded history , roughly 4,000 BC.

But opiates and opioids have always been derived from plants, especially the opium poppy. Their molecular structure is so complex, that scientists have never been able to duplicate them in the laboratory – until now.

Now, the UCB team has accomplished that task by engineering yeast to perform a crucial step in the synthetic opioid-producing reaction. A special enzyme was isolated from sugar beets, then genetically altered to make it “more productive” and then combined with the yeast. Additional foreign DNA was added to the yeasty brew, and voila! The specially formulated yeast completed the step needed to produce opioids.

“The whole process can be made more efficient,” said John Dueber, the lead UCB researcher. “It’s now a matter of linking all the steps together and scaling up the process.”

Less addictive, more effective pain relievers, but…

Discussion is ongoing about the possibility that this new research could lead to cheaper, less addictive and more effective pain-killers.

But most observers are more concerned that an easy, morphine-making yeast could significantly increase the availability of illegal opioids. And we’re already in a pills-and-opioids epidemic right now.

Comments from drug policy analysts published with the UCB study agreed that it could make illegal drugs “easy to grow, conceal and distribute” with little more than a home-brew beer-making kit. One suggested solution called for new policies to regulate engineered-yeast strains and confining them to “licensed facilities.”

But as the news service Reuters pointed out, the cat may be out of the bag. The recipe for opiate-producing yeast has already been made public. And “anyone trained in basic molecular biology could theoretically build it,” Dueber said.

Well, it’s not like you or your teenagers will be whipping up some morphine in your kitchen or basement workshop any time soon – and hopefully, it will be never. A degree in “basic molecular biology” isn’t all that common.

Meanwhile, here at Novus, we’re still doing our part in combating the opioid epidemic by providing the most advanced and successful medical opioid detox anywhere. So if you or someone you care for needs help with substance use or abuse, don’t hesitate to call us right away. We’re always here, helping people get their lives back.

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A judge in Kentucky with decades of experience dealing with drug crimes and addictions says the state’s commitment to Suboxone to treat opioid addiction simply isn’t working.

Kentucky Drug Court Judge David A. Tapp says Suboxone is not the solution to the state's opioid addiction problems.Kentucky Drug Court Judge David A. Tapp, who serves Lincoln, Pulaski and Rockcastle counties in the 28th Judicial District, says he’s seen enough problems with Suboxone opioid addiction treatment to know it’s causing problems, not solving them.

Judge Tapp, who was awarded the prestigious National Association of Drug Court Professionals ‘All Rise’ award a few years ago, knows a thing or two about opioid addiction, treatment and drug-related crime. And he says Suboxone, which is itself an opioid, is more often than not being diverted and sold by addicts to pay for pills and heroin.

In an column he wrote for the Lexington Herald-Leader, Judge Tapp said that the newspaper’s recent claims that Suboxone will reduce addiction and overdose deaths is, to put it mildly, dead wrong.

“A recent Herald-Leader editorial,” Judge Tapp wrote, “supported using Suboxone (buprenorphine and naloxone) to treat opiate addiction. The editorial claims that with more taxpayer-funded Suboxone, opiate abuse and overdoses will decrease.

“Unfortunately, recent history demonstrates otherwise.”

The judge pointed out that Suboxone prescriptions are “rising dramatically within Kentucky — from approximately 5.6 million doses in 2011 to 11.6 million doses last year. Statistics from the Cabinet for Health and Family Services reveal that Medicaid alone paid approximately $27.6 million for buprenorphine products last year in Kentucky. It was the No. 2 drug in Medicaid costs last year.

“If more Suboxone equated with fewer overdose deaths and decreasing opiate dependence, we might have more to show for the nearly 34 million doses of Suboxone peddled within Kentucky since 2011,” Judge Tapp said. “Instead, opiate abuse abounds and our citizens continue to die.”

And even though Suboxone is widely available, Judge Tapp said, “it hasn’t slowed the rising prevalence of opiate addicted babies. Hospitalizations for addicted newborns continue an alarming climb — from approximately 29 in 2000 to well over 700 in 2011. Nearly 824 addicted infant hospitalizations were identified in 2012.”

The Herald-Leader editorial said that if used as prescribed, “the substitute drugs enable users to function normally, hold a job, go to school, without the impairment and craving that drive abusers to crime and other risky acts.”

Judge Tapp’s experience with drug courts presents an entirely different viewpoint.

“Unfortunately, Suboxone is frequently abused,” he said. “The real world is flooded with medication diverted from legitimate sources, long-term offenders who often test positive for Suboxone smuggled into jails, and hapless defendants who repeatedly report long-term opioid maintenance with no real path toward sobriety.”

The judge referred to the Food and Drug Administration’s warnings that “buprenorphine, like morphine and other opioids, has the potential for being abused and is subject to criminal diversion.”

The FDA cautions that Suboxone “may impair the mental or physical abilities required for the performance of potentially dangerous tasks such as driving a car or operating machinery.”

“Why?” asked the judge rhetorically. “Because Suboxone is a narcotic!”

Diversion of Suboxone is widespread in Kentucky. One of the state’s drug court actions is to perform drug tests on criminal defendants. From July last year through this past April, Kentucky administered 191,201 drug tests.

“Of those, 2,695 were positive for the illegal use of Suboxone and methadone — the very same dangerously addictive drugs which the Herald-Leader suggests are currently insufficiently available,” Judge Tapp pointed out.

“Our families, neighbors and communities need a real alternative to addiction — whether that addiction is to street drugs or to the medication prescribed to treat such addiction. No one should be satisfied with maintaining addiction, no matter the drug,” Judge Tapp said.

At Novus, we concur.

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Categories: Suboxone #

When the prescription opioid painkiller Numorphan in pill form was taken off the market 36 years ago in 1979, most people working in addiction treatment breathed a sigh of relief.

Throughout the 1960s and ‘70s, Numorphan (generic name oxymorphone) was seen to be responsible for countless thousands of addictions and overdose injuries and deaths. One of the most commonly abused prescription opioids at the time, the pills were usually dissolved and injected by addicts, many of whom preferred it to heroin.

By 1979, swayed by the wave of oxymorphone addictions and deaths across the country attributable to Numorphan, the FDA and the drug’s maker, Endo Pharmaceuticals, removed Numorphan tablets from the market. The injection and suppository forms of Numorphan were allowed to stay on the market and are still in use today.

So after a deadly 20-year run – it had been approved in 1959 – the pill form of Numorphan disappeared from pharmacy shelves in drug stores and hospitals across the country. Neither the FDA nor the drug maker admitted any connection to the 20-years-long Numorphan epidemic for its removal.

But then, in 2006, for some utterly inexplicable reason (well, on the surface at least) the FDA approved Endo Pharmaceutical’s application to approve the same drug all over again, but under a new trade name – Opana.

The FDA approved both Opana immediate-release and Opana ER for extended release. And then in 2011 the agency approved an “abuse-deterrent” version which, as with similar pills like abuse deterrent OxyContin, abusers are easily defeating the anti-injection properties of and are shooting up Opana like there’s no tomorrow.

The effects of Opana abuse are closer to those of morphine than of other widely abused opioids like OxyContin (extended release oxycodone). According to NYPress.com, OxyContin has “a more stimulating effect” than Opana, which can cause users to fall asleep. Like morphine, Opana’s greatest danger to abusers is the possibility of respiratory depression, the major cause of overdose death.

In addition to the ever-present risk of overdose, sharing needles among a large group of Opana abusers has been found responsible for a massive outbreak of HIV and hepatitis C infections in rural Austin, Indiana, and several Appalachian states.

The new Opana, according to a report in MedPage Today, is also associated with a blood-clotting disorder and permanent organ damage, problems that didn’t occur with injection abuse of earlier version of the drug, Numorphan, or injection of generic oxymorphone.

In addition to the tragedies associated with addiction and spread of disease, there’s another disturbing aspect of this whole Opana thing. When the FDA approved Opana, there already were dozens of other narcotic painkillers on the market. And plenty of them were already complicit in tons of cases of crime, abuse, overdose and deaths.

Why in the world would there need to be yet another opioid painkiller on the market, and one with a proven track record of destruction?

“There certainly didn’t seem to be a need for it,” said James Roberts, MD, a professor of emergency medicine at Drexel University College of Medicine in Philadelphia. As quoted in MedPage Today, Roberts added that “there are plenty of narcotics around for pain relief.”

As we’ve reported in earlier blogs and articles, the Milwaukee Journal Sentinel and MedPage Today collaborated on an investigation of oxymorphone’s “re-appearance” on the market. The investigative reporters observed a pattern of drug approvals over a decade or more, including “cozy relationships between regulators and drug company executives and the use of questionable clinical testing methods allowed by the FDA.”

Throughout the 2000s, records show, there were regular meetings of drug company execs, federal regulators and various academics involved in drug development, under the auspices of an organization funded by pain drug companies. These meetings were the subject of a 2013 Journal Sentinel/MedPage Today investigation. And Opana’s Endo Pharmaceuticals was a frequent attendee.

“The nation’s leading pharmaceutical companies paid entry fees running into the tens of thousands of dollars to attend invitation only conferences with FDA and NIH officials,” the reporters wrote. “Entry to these meetings was secured by annual fees from $20,000 to as high as $35,000. The drug companies that paid those fees were guaranteed the right to send a representative to the annual meetings.” And many of the academics invited to these closed-door meetings were offered payments of about $3,000 to attend.

The ostensible purpose of the meetings has been to come up with ways to fast-track drug trials – cutting back on almost every aspect of testing, even removing test subjects who suffer from side effects from the statistical outcomes.

Another thing: When Endo tried to get Opana approved in 2003, reports MedPage Today, the FDA said the drug didn’t appear effective enough in clinical trials. And there were safety concerns after several pain patients overdosed on the drug and had to be revived with emergency doses of naloxone.

Endo promptly removed anyone from the study who didn’t respond well to the drug, and the FDA approved it.

These approaches “essentially stack the deck in favor of the drug,” says MedPage Today. “More importantly, experts say, drugs tested that way are not likely to reflect what will happen when a drug gets on the market and is prescribed for large numbers of people.”

“It’s in fact cheating,” said Patrick McGrath, PhD, a pediatric pain expert at the Dalhousie University in Halifax, Nova Scotia.

The whole affair reeks of something resembling “pay to play” – not how the FDA is authorized to protect the American public from harm. For its part, the FDA denies any pay-to-play funny business.

But there’s no explanation to justify the approval of yet another dangerously addictive opioid painkiller into a world already awash in painkillers, a world already crushed by a prescription painkiller addiction epidemic.

Meanwhile, doctors are writing close to 800,000 Opana prescriptions a year. And Endo Pharmaceuticals is grossing an average $450 million a year.

And thousands of opioid addicts are finding plenty of Opana to go around, too.

If you or someone you care about is in trouble with drugs or alcohol, call Novus and get the help you need.

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Categories: Drug News, Painkillers #

The small and almost unknown town of Austin, Indiana – population 4,200 – is the center of the worst surge in cases of HIV and Hepatitis C in state history. And the epidemic is stemming entirely from one drug – Opana ER extended release oxymorphone – being injected with shared needles.

Although Opana ER is made in an “abuse deterrent” form, users easily have discovered how to get around that mechanism, said Dr. Jerome Adams, Indiana’s State Health Commissioner. “It’s important that we all understand that just because a drug comes in an abuse deterrent form, that doesn’t automatically make it safe.”

By April of this year, the number of confirmed cases of HIV in southeastern Indiana had climbed to 136 just since November 2014. And this is in a region that historically has seen less than 5 cases a year. Meanwhile, there were six additional preliminary cases, said CDC officials, awaiting confirmation. If positive it would bring the total to 141.

Added to the HIV, co-infection with the Hepatitis C virus (HCV) also has been diagnosed in nearly 85 percent of patients.

The number of HIV cases rang alarm bells all the way from rural Indiana to the CDC. The state’s chief medical consultant told a CDC briefing that roughly four out of five infected patients reported injection drug use, while some of the others reported partners as injection drug users.

In Scott County, where most of the current infections are, fewer than five cases of HIV per year have been reported in the past. “This is the first outbreak of its type that we have seen documented in recent years,” said Dr. Jonathan Mermin, director of the National Center for HIV/AIDS in Atlanta.

Opana ER and shared syringes – a deadly combination

The majority of cases have been linked to dissolving tablets of the prescription opioid oxymorphone (Opana ER or Extended Release) and injecting it using shared syringes.

“We have not seen an outbreak of HIV specifically associated with the injection of oral opiates previously,” Mermin said. And the Indiana State Department of Health said that the injection drug use is “a group activity in this population” – with as many as three generations of a family, along with multiple community members, all injecting together and sharing needles.

Patients have ranged in age from 18 to 57 years and are on average 35 years old. A total of nearly 55 percent are male.

Opana (oxymorphone) has a half-life of approximately 4 hours. That means dependent users begin to feel withdrawal symptoms around that time. “We have heard that folks are injecting from 4 to over 10 times a day,” one official said.

Once crushed, the Opana pills are less “dissolvable” than, for example, heroin. The anti-abuse formula renders it thick and lumpy, requiring a thicker gauge needle to inject. “That is making the sharing of needles an even higher risk activity,” said Health Commissioner Adams, “because you’re being inoculated with higher amounts of HIV virus.”

Needle exchange programs are currently illegal in Indiana, so the only recourse for addicts is to buy or steal new needles, or share used needles. In late March, Indiana Governor Mike Pence (R) signed an executive order authorizing a 30-day needle exchange program, and then was persuaded to extend the program for another 30 days. But needle exchange alone “is minimally effective,” said Adams, “so it must be part of a comprehensive response.”

Indiana has a prescription drug monitoring program that lets health officials give physicians feedback about their prescribing habits, Adams said. The state also is taking “a four-pronged approach to the outbreak” that includes the development of a ‘one-stop shop’ that provides testing, treatment, and follow-up; a needle-exchange program now being offered by the Scott County Health Department; a public awareness campaign and additional HIV testing and treatment at a local health clinic.

“This outbreak that we’re seeing in Indiana is really the tip of an iceberg of a drug abuse problem that we see in the U.S. that is putting people at very high risk for infectious diseases,” Adams said.

And the CDC has released a health advisory to alert healthcare providers and health departments of the HIV outbreak and HCV co-infection. The advisory details how to identify and prevent the spread of HIV and HCV and urges providers to refer patients with substance abuse problems for medication-assisted treatment and counseling.

The principal adverse effects of Opana (oxymorphone) are similar to other opioids. The most common are constipation, nausea, vomiting, dizziness, dry mouth and drowsiness. Of course, it’s highly addictive and can lead to dependence, withdrawal symptoms or overdose.

Here at Novus, we routinely achieve great success treating dependencies to prescription opioids such as Opana ER. If you or a loved one needs help with an opiate dependence, don’t hesitate to call Novus. We’re always here to help.

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Neuroscientists at Washington University School of Medicine in St. Louis have found a way to activate the brain’s pain-relieving mechanism using nothing but light.

Although the research is in the very, very early stages, the scientists say that some day in the future, doctors might be able to treat pain with safe, non-addicting doses of light, instead of the dangerous and addictive opioids in such wide use today.

To understand how the light idea works, we first need to know that all those opioid pills and injections we call “painkillers” are in fact not painkillers at all. They simply flip some switches in our brains and body that activate the body’s own natural pain-relieving system.

The second thing, and really the only other thing we need to know, is this really big news:

According to the research, the body’s pain-relief switches can be flipped on using something other than opioids – in this case, simple light.

How opioids work

When we take opioids, they interact with special receptors in our brains and body called “opioid receptors.” In simple terms, this causes the receptors to initiate biochemical activity in specific chemical pathways, reducing our sensitivity to pain.

So painkilling ability is not contained in the opioid painkillers – our own bodies have that ability. Opioids are just the activators – they flip the switches that turn on the body’s own painkiller system.

We’ve  called these switches “opioid receptors” because opioids have been the only substances known that so quickly and thoroughly switch on the body’s built-in painkilling system.

The question has been: What if some other substance, a non-opioid with no side effects, could be found that will flip these switches – something that is neither dangerous nor habit-forming?

That’s what the researchers at Washington University were trying to find out. And they say they’ve found a very exciting possibility.

The search for alternatives to opioids

Searching  for some other non-opioid substance that might activate the opioid receptors could take, literally, forever. You might never find anything that works. Furthermore, no one is exactly sure how these receptors even work – not in complete detail, anyway. They’re complex, and in fact do a lot more than just regulate pain.

Instead, the scientists decided to try altering the receptors themselves. Perhaps they could make the receptors sensitive to some known substance – one they could select in advance. If it worked, perhaps it could lead to better pain-killing drugs – ones with fewer side effects.

They decided to test the theory using a light-sensing protein called rhodopsin, which senses light in the eye’s retina. If they could somehow combine rhodopsin with opioid receptors, maybe  the receptors would “switch on” with light instead of needing opioids.

In the lab, the scientists were able to merge light-sensing rhodopsin into key parts of opioid receptors, creating new receptors that respond to light in exactly the same way that standard opioid receptors respond to opioids.

They injected these altered receptors into the brains of lab mice, and the results were astonishing. When the researchers shone light on the receptors that contained rhodopsin, the same cellular pathways were seen to become activated. The mice reacted to light in the same way that normal mice – and people for that matter – react to opioids.

The researchers were able to vary the animals’ response depending on the amount and type of light. Different colors, longer and shorter exposures and pulsed or steady light all produced slightly different effects.

Will light or other substances just act the same as opioids?

Opioids can create tolerance, dependence and addiction. They can interrupt normal breathing and function of the central nervous system, called overdose. There are many other side effects.

Will receptors altered to respond to light act the same as the standard ones do with opioids?

The researchers wrote that, in theory at least, receptors tuned to light may not present the same dangers. In fact, they say that someday it may be possible to activate, or deactivate, painkilling nerve cells without affecting any of the other receptors that today’s opioid painkillers trigger – the ones that potentially lead to tolerance, dependence and overdose.

And if pain patients have to have altered light-sensitive receptors injected into their bodies, how will you ever turn them off when the painful condition is healed? Or will people have to spend the rest of their lives avoiding light?

Many unknowns remain, and the questions are fascinating. Hopefully more research will tell us in more detail what the future might hold. The goal is pain control without side effects or dangers. Perhaps science can answer this need and bring an end to the scourge of opioid addiction and accidental death.

Meanwhile, here at Novus, we’re busy dealing with the real world of today – the seemingly endless problems of opioid painkiller use and abuse. And the message is this: Don’t hesitate to pick up that phone and call us if you or someone you care about is troubled by drugs or alcohol. We’re the experts, and we’ll do our level best to answer all your questions and get you the help you need.

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According to the latest National Survey on Drug Use and Health, Rhode Islanders continue to use marijuana and illicit drugs at the highest rates in the nation.

The findings, says a news report in the Providence Journal, were no surprise to local experts who have long seen the state at the top of numerous categories of the annual survey over the years. “Nevertheless they remain somewhat mystified about the causes,” the news article said.

Another current survey by polling company Gallup found that Rhode Islanders rank second highest in the country in the use of all drugs – both illicit and legal prescriptions – just behind West Virginia and ahead of the number three state, Kentucky.

Fourteen percent of Rhode Islanders age 12 and older reported using marijuana in the past month – up from 13 percent last year, and more than any other state. This puts R.I. at twice the national average of 7.4 percent, the report said.

Rhode Island was also tops in the nation for using marijuana in the previous year: 20 percent, up from 19 percent last year.

Not surprisingly, there’s a powerful movement in the state to fast-track a legalize-marijuana bill that’s making its way through the legislature. Rhode Island already is one of 23 states and the District of Columbia that has legalized medical marijuana for licensed patients. The coalition behind full legalization, if successful, would make Rhode Island the fifth state to legalize marijuana.

Meanwhile, said the report in the Providence Journal, Rhode Islanders “also led the nation in consuming illegal drugs, excluding marijuana. About 4.3 percent reported having taken them in the month before being surveyed.”

Although the survey is “probably an accurate portrayal…we’ve seen trending for a long time, the ‘why’ is really hard to answer,” said Rebecca Boss, deputy director of the state Department of Behavioral Healthcare, Developmental Disabilities and Hospitals.

And Michael Rizzi, president and CEO of the substance-abuse treatment and prevention agency CODAC, said that regardless of why the state has such high level of drug use, relaxing marijuana laws and greater societal acceptance of the drug, should that happen, could make matters even worse.

“The issue of prevention has always been something of importance,” Rizzi said. “Marijuana, for many people, seems to be an innocuous product, and with the relaxing of the laws in Rhode Island, it makes it easier for people to make a choice, one that includes thinking ‘at least I don’t have to worry about being arrested.’”

The annual survey, conducted since 1971 by the U.S. Substance Abuse and Mental Health Services Administration, is based on interviews with randomly selected individuals.  The survey doesn’t rank the states in the various categories of drug and alcohol use, but their relative standings can be deduced by examining the numbers.

State Healthcare’s Rebecca Boss said that her agency “pays attention to the survey results” and does take action as a result. For example, Rhode Island used to land at the top of the charts for underage drinking, which led to the introduction of state-wide initiatives to deal with it. As a result, the underage drinking statistics have declined.

The state is now using a federal “Partnership for Success” grant to help address public perceptions of marijuana and other drugs. “If the perceived risk goes down, the use goes up,” she said. “We are trying to be proactive and get ahead of this. We think we have programs in place that may not have an immediate impact, but will in years to come.”

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Categories: Marijuana #

Pain specialists have suspected for years that opioid painkillers are somehow related to symptoms of depression in chronic pain patients. A new study published in the medical journal Pain shows that those suspicions were indeed correct.

As chronic pain patients increase their dosage of opioid medications, says the study from Saint Louis University, they are more likely to risk the symptoms of depression or increase the symptoms of an existing depression.

But a follow-up study shows that it actually may be how long you take opioids, not how much you take, that is the real cause of increased depression. Analyses of thousands of VA patient records showed that the longer that chronic pain patients took opioids – regardless of the dosages – the greater were the chances of depression setting in or getting worse.

Jeffrey Scherrer, Ph.D., associate professor for family and community medicine at Saint Louis University, said that since the study was published in Pain, his group has conducted additional analysis of a large VA patient data base with the support of NIH funding.

The researchers wanted to see what the relationship was between duration of opioid use and the dose of opioid. Did these two factors interact? Do they have an additive effect on risk of depression?

“Our results support the conclusion that most of the risk of depression is driven by the duration of use and not the dose,” Scherrer said.

The researchers explained that the initial findings that increasing the dosage of opioids appeared to increase the risk of depression was hiding the real causes. Chronic pain patients who take opioids over long terms, Scherrer explained, tend to increase their dosages because of the buildup of tolerance. As the tolerance increases, patients require higher doses to achieve the same level of effectiveness.

“Thus, a strong potential explanation of our finding that increasing opioid dose increases risk of depression could be that the patients who increase dose were the longer using patients. This is logical as longer use is associated with tolerance and a need to increase opioids to achieve pain relief,” he said.

One of the goals of the continuing research is to discover more about the possible relationships between opioid dosages and the length of time taking them with new depression vs. stirring up past episodes of depression. Such data could help both pain management physicians and patients fine tune therapies to head off potential bouts of depression.

“We hope to find risk factors such as opioid misuse that could be in the pathway from chronic opioid use to new onset depression,” Scherrer said. “This would expand the targets for intervention to limit the risk of depression in patients who need long-term opioid therapy.”

One of the many pleasures we experience here at Novus is sharing in the lightening and brightening of patients as they shed the months or years of depressing opioid dependence. Helping patients get free from the effects of opioids is a serious activity, but we all enjoy the huge smiles at the end of those few crucial days of Novus life-changing medical opioid detox.

If you or someone you care about is in trouble with opioids – heroin, methadone or narcotic painkillers like oxycodone, hydrocodone, hydromorphone and all the others, don’t hesitate to call us here at Novus. We’ll do our expert best to answer all your questions.

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It’s apparently no coincidence that the states ranking lowest for a sense of wellbeing among its citizens are also the states with the highest consumption of mood-altering drugs.

A nationwide Gallup poll, called “The State of the States” poll, has found that Kentuckians, Rhode Islanders and West Virginians consume the most mood-altering drugs, both prescription and illicit, in the nation.

And another Gallup poll has found that the least happy and satisfied people in the nation live – guess where: West Virginia and Kentucky and to a lesser extent, Rhode Island.

Anyone with an interest in drug use and abuse, drug addiction and treatment, should pay attention to these two polls. They reveal a lot about why people get caught up in drugs and alcohol. And they may help point the way to a faster, more successful recovery.

Every drug and alcohol user has his or her own reasons for consuming more than is considered healthy. But the Gallup polls suggest that each person’s story likely includes some of the common depression and lack of fulfillment that is widespread in each state.

And when more people all around you are using so many drugs and alcohol, a tacit sort of agreement about it can begin to filter into the community. The whole take-a-pill-or-smoke-a-joint-when-you’re-feeling-down thing takes on a sort of legitimacy. It breeds and spreads and becomes “the norm.”

Gallup’s “State of the States” survey polled 450 residents from each of the 50 states. It asked how often they took mood-altering drugs or medication, including prescription drugs, “to help them relax” – that is, try to make the rest of your crappy day a little better than it usually is.

West Virginians reported using such substances the most – 28 percent said they took drugs to relax almost every day. Rhode Islanders were next, at 25.9 percent, and Kentuckians were third with 24.5 percent. Alaskans reported the least drug use with only 13.5 percent.

The other Gallup poll found West Virginia and Kentucky two of the lowest-ranking states in terms of a simple sense of wellbeing.

“It’s no coincidence that drug use was inversely proportionate to the wellbeing score,” said lead researcher Dan Witters. In other words, the worse you feel about yourself and life the more drugs you reach for on a daily basis. Witters said that these feelings “increase the chances of drug use.” He pointed to such factors as obesity or even poor workplace performance contributing to a feelings of depression, a sense of low self-esteem and generalized stress – all of which can lead to drug use as compensation.

When a quarter of the population can’t – or won’t try to – get through a day without some sort of chemical assistance, there’s definitely something wrong going on. Whatever that is, these states are also among the highest in the nation for heroin and prescription opioid addictions and overdose deaths, marijuana use among teenagers, and alcoholism.

And when there’s a lot of agreement that taking drugs is an okay thing to do, you tend to see an escalation of it. And before long, it leads to dangerous drug abuse and all the tragic results that go along with that.

According to a Medical Daily report, the Gallup wellbeing survey noted that the keys to more wellbeing are found in “a variety of health, workplace and societal factors, from obesity status to the development of disease, and workplace performance to crime rates.”

Gallup defined the “five elements of wellbeing” as purpose, social, financial, community, and physical health. “States and local communities can use wellbeing concepts and the five elements as focal points in designing initiatives to improve wellbeing,” the Gallup poll said. “It’s likely that if people have a sense of wellbeing in these areas, they’d be less likely to use drugs.”

Here at Novus, we are frequently reminded of the complex personal battles being waged (and won) by our patients, and how these issues relate to the larger areas of their lives – often close to those “five elements” as seen by the Gallup pollsters.

If you or anyone you care for is using mood-altering substances to “relax and just get through the day” don’t hesitate to call us. We’ll do our best to answer your questions and see that you get the best and most appropriate help available.

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Categories: Drug Facts, Drug News #

The governor wants to end state funding for methadone treatment for opiate addiction and put everything into Suboxone, which has sparked heated arguments. Strangely silent are the majority who actually favor detox and abstention as standard treatment.

Nearly 4,000 Maine residents are receiving methadone treatment for opiate addiction under the state’s MaineCare (Medicaid) program. But Gov. Paul LePage wants to do away with methadone treatment entirely, and has introduced a budget that would end financial support for methadone, and switch everything to Suboxone and other drug treatments.

There are several big problems with the idea, and LePage and his cronies can’t seem to get their minds around any of them. At odds with LePage’s plan are almost everyone in the state who has a stake of any kind in opiate addiction treatment.

Addiction specialists, doctors and substance abuse specialists of all kinds are up in arms at the government’s plan, which they say ignores all scientific data. In fact, LePage’s own spokespeople admit that the governor’s plan is based entirely on finances with no regard whatsoever for science and research. The plan offers no suggestion at least for a pilot program, and apparently cares little or nothing for public opinion.

What about America’s favored treatment – abstention?

Recent national surveys show that the majority of Americans strongly believe that abstention from all drugs is the best and only way to approach opiate and other drug addictions. Most Americans don’t see any logic in switching a drug addict from one drug to another drug, often for years at a time.

Except for the rarest and most extreme cases, neither do we. Here at Novus, we’ve seen too many wonderful recoveries – countless recoveries – to buy into the drug-switching approach to treatment.

Yet the majority of Americans, people who favor safe medical drug detox followed by long-term effective rehabilitation, are not only not included in much of the ongoing debate, they’re being ignored by the state’s major news media.

This situation serves to enforce the idea that the only approach to treating opiate addiction is prescribing more drugs. Of course, nothing could be further from the truth. Every day of the week people are recovering from opiate addiction at detox and rehab centers across the country.

So what will happen if the governor gets his way?

What will happen if the plan to cut state funding for methadone clinics becomes law? A whole kettle-full of problems has surfaced during the debate:

  • Suboxone is considered effective for opiate addicts with “less severe addiction.” It has clearly been shown ineffective and even dangerously so for longer-term addicts. Assigning everyone to Suboxone is absurd and actually medical malpractice.
  • Suboxone is not some heaven-sent cure for anything, and it has its own problems. It is more easily diverted to addicts without a prescription than methadone. It can have deadly side effects when combined with alcohol and other medications. And the latest info from law enforcement is that it’s gaining a lot of favor in the underworld, especially in prisons, where it’s smuggled in on a regular basis.
  • Suboxone costs much more than methadone, yet the governor wants to enact a law based on a perceived idea that it will cost the state less than methadone. There are a lot of figures being quoted, some saying he’s right, others that he’s way wrong.
  • Suboxone must be administered by certified physicians, generally primary care doctors. Certified doctors can only treat 100 patients at a time and there aren’t nearly enough certified doctors in Maine to handle the volume now.
  • The needed number of certified doctors couldn’t possibly be reached in time for the governor’s deadline. In fact, some observers say there aren’t enough doctors in the state who are willing or even interested enough in such a program to apply for Suboxone certification.
  • Many of the 3,800 addicts on MaineCare currently receiving methadone at the state’s 11 clinics will be left with no available state-funded treatment. Hundreds will be faced with no other choice to stave off withdrawal except relapse – a return to the streets, to heroin and illicit opioid pharmaceuticals, to lost jobs and alienated families, to HIV and other shared needle infections and to the ultimate end – death from overdose.

Again, what about detox, rehab and abstention?

Throughout this debate, there’s been precious little input from those who believe in abstention – almost nothing in the news. It’s all about alternative drugs to treat drug problems.

There are some very powerful influences, let’s just call them “the drug lobby,” pushing for the use of drug alternatives as the only way to treat opiate addiction. Statistics supporting these drugs, and vilifying traditional detox and rehab, are highly suspect. Yet they reach all the way to federal health care levels, even the White House.

Here at Novus, we see daily evidence of the effectiveness of modern medical detoxification protocols. People are winning by abstaining from drugs, and they’re returning to their lives drug free – not shackled for who knows how many years to a methadone clinic or a doctor’s office.

If you’re in need of some help with a drug problem, call us and we’ll do our experienced best to answer your questions and get you or your loved one on the road to full recovery.

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